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Spiritual and Religious Factors in Depression : The State of the Science. Michael E. McCullough University of Miami. Religion and Health: Damned by Overstatement?.

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spiritual and religious factors in depression the state of the science

Spiritual and Religious Factors in Depression : The State of the Science

Michael E. McCullough

University of Miami

religion and health damned by overstatement
Religion and Health: Damned by Overstatement?

“Based on the research data we how have at hand, your doctor could--from a strictly scientific point of view--recommend religious involvement to improve your chances of being able to . . . Stay healthy and avoid life-threatening and disabling diseases like cancer and heart disease...[and] live longer.” (p. 15).

religion and health damned by understatement
Religion and Health: Damned by Understatement?

“Serious methodological and empirical issues continue to plague the literature on religion and health. Even well-conducted studies demonstrate only a weak or nonexistent association.” (p. 350)

our approach
Our Approach
  • Based on ALL available evidence, what can we say about the relationship of religious/spiritual factors and health (viz., depression)?
  • For whom, and under what conditions, does the association apply?
  • What do we know about the temporal dynamics of the association?
  • What are the active ingredients?
religiousness and well being in adulthood
Religiousness and Well-Being in Adulthood
  • Meta-analysis of 56 effect sizes
  • Mean ES of r = .16
  • Mean ES for religious activity of r = .18
  • Mean ES for subjective religiousness of r = .13

Witter et al. (1985)


Dimensions of Religiousness and Likelihood of Diagnosis with Nine Major Mental Disorders

Kendler et al., 2002

religiousness and recovery from depression
Religiousness and Recovery from Depression
  • 87 patients aged  60 admitted for physical illness with co-morbid depression.
  • Patients with higher intrinsic religiousness scores (score range 10-50) experienced faster recovery
  • Every 10 point increase in intrisinc religiousness score associated with 70% increase in speed of remission.
  • Koenig HG, et al.Am J Psychiatry 1998;155(4):536-542
meta analysis
  • A family of statistical methods for aggregating observations from multiple studies
  • Each study contributes an estimate of the association of religious involvement and mortality
  • Estimates aggregated into one population estimate
advantages of meta analysis
Advantages of Meta-Analysis
  • Allows researchers to examine the consistency of findings across studies
  • Permits statistically based estimates for an entire body of research
  • Permits empirical investigation of the sources of variability among studies
weaknesses of meta analysis
Weaknesses of Meta-Analysis
  • Garbage In, Garbage Out
  • Apples and Oranges
  • Publication Bias (or the “File Drawer” Problem)
150 Studies

Mean Correlation of Religiousness and Depressive Symptoms = -.126

Findings almost = for both genders and across ethnic groups

Effects of Positive vs. Negative Religious Coping

Effects of Intrinsic vs. Extrinsic Religiousness

Age differences


Smith, McCullough, & Poll, 2003

how do people use religious and spiritual beliefs to cope
How Do People Use Religious and Spiritual Beliefs to Cope?
  • Styles of Religious Coping
    • Self-Directing
    • Deferring
    • Collaborative
  • Specific Ways of Religious Coping
    • Positive vs. Negative
    • Specific Religious Coping Processes (Demonic Reappraisal, Seeking Congregational Support, etc.)
spiritual strengths
Spiritual Strengths
  • Gratitude
  • Forgiveness
  • Hope/Optimism
  • Humility/Accurate Self-Esteem
  • Control of the Self
  • (Giving and Receiving) Love
the religion mental health connection not magic
The Religion-Mental Health Connection: Not Magic

“It seems to me most important for the whole problem of religion and health to recognize that the magical world view is not religion. . .Religion is not magic, and magic is not religion.”

Paul Tillich, 1958, “Religion and Health”